The case for value-based care
Health systems from India to Nigeria suffer from a crisis of distrust. Patients question the quality of government clinics. Newspapers expose private hospitals for peddling unnecessary procedures. These are symptoms of volume-based health systems that focus on the quantity of care delivered and rather than quality or outcomes. Many countries are accelerating down this path. Hospital construction surpasses growth of primary care infrastructure. New insurance schemes expand access to inpatient treatment, without equivalent expansion of community-based prevention. Adhering to this path will create long-lasting structural flaws which increase costs without delivering desired results.
We have a narrow window to chart a different trajectory and leapfrog to a value-based approach. Value-based care focuses on outcomes that matter to patients and optimizes the costs to achieve those outcomes. Providers deliver the highest-value interventions, whether biomedical, social, behavioral, or environmental. Payment models reward value, rather than volume.
About the report
The report offers a human and economic case for value-based care, highlights innovators applying value-based care principles in LMICs today, and offers a strategy for transformation.
Key takeaways
Achieving universal health coverage will require a paradigm shift from volume- to value-based care. Leapfrog to Value calls on donors and governments to start taking action now.
Quality of care is essential to achieving the health SDGs. Value-based care is an innovative strategy to help countries establish high quality health systems.
Countries like India, Kenya, and South Africa are beginning to experiment with value-based care. Investing in more experimentation and scaling what works will position LMICs to leapfrog their higher income peers.
Value-based care can help address 9 of the 16 million avertable deaths in LMICs per year, and can help reduce the USD 250 billion per year of waste that exists in LMIC health systems.
About the Leapfrog to Value Initiative
The L2V report highlights immediate opportunities to hasten a value-based care transformation:
Cultivate experimentation to develop locally-relevant healthcare models that maximize value for patients.
Apply a value lens to near-term investments that have lasting implications, particularly investments in digital health systems and provider infrastructure.
Leapfrog to value by establishing the data standards, capabilities, policies, and evidence required to scale value-based care.
The L2V initiative is building a coalition to take action on the report’s recommendations:
Experimentation: We launch, test, and scale value-based care pilots in partnership with public and private payers and providers.
Advisory: We advise governments and private sector clients on how to incorporate value-based care principles into their digital health strategies. We advise investors who want to incorporate value as a criteria in their diligence.
Advocacy: We highlight policies that will help scale successful value-based care pilots. We demonstrate the business case of value-based care to private stakeholders.
Contributors
Steering Committee
Amy Lin, Acting Director, Center for Innovation and Impact, United States Agency for International Development
Amy Pollack, Director, Maternal, Neonatal, and Child Health, Bill & Melinda Gates Foundation
Andrew Stern, Founder and CEO, Global Development Incubator
Chintan Maru, Founder and Executive Director, Leapfrog to Value
Jean Kagubare, Deputy Director, Integrated Delivery, Bill & Melinda Gates Foundation
Jeff Walker, Co-Chair, Community Health Acceleration Partnership, Hosted by WHO Ambassador for Global Strategy
Naveen Rao, Managing Director, Health, Rockefeller Foundation
Acknowledgements
The following individuals made significant contributions to the development of this report
Danielle Dobos, Former Consultant, Dalberg
David Milestone, Former Director, CII, USAID
Monisha Ashok, Market Access Advisor, CII, USAID
Foreword by Margaret E. Kruk, Harvard T.H. Chan School of Public Health, Chair of Lancet Global Health Commission on High Quality Health Systems
Funders
Launch partner
Leadership
Chintan Maru
Founder and Executive Director
chintan.maru@leapfrogtovalue.org
Chintan Maru is a medical doctor and public health expert who has dedicated his career to maximizing the value of health systems. In addition to leading the Leapfrog to Value initiative, he directs the Global Development Incubator’s health portfolio.
Previously, Chin was a consultant in McKinsey & Co’s health systems practice, where he led value-based care reforms for payers, providers, and state governments in the United States; and advised on public sector delivery transformations in sub-Saharan Africa. Chin is a graduate of Johns Hopkins School of Medicine and majored in political science at Duke University. He was a Public Policy and International Affairs Fellow at Princeton University and a US Fulbright Scholar to Jamaica.